Autism is a common term for a number of overlapping syndromes. It has no standard or universally accepted form of treatment, and parents and practitioners alike have access to numerous therapies in trying to improve a child’s autism spectrum disorder (A.S.D.). The use of these other therapies has significant implications for homoeopathic treatment. Some approaches, such as dietary changes, can be combined relatively easily with homoeopathy; others, such as chelation or neuroleptic drugs, can make homoeopathic prescribing almost impossible. If homoeopaths wish to effectively help the A.S.D.-affected children who increasingly present at their clinics, it is important to be familiar with these other competing and often antagonistic strategies and the impact they may have on their homeopathic treatment.
- Biomedical Interventions
- The Biomedical Approach: What is It?
- The Biomedical Approach: Four Categories
i. Intervention 1: Dietary Modification
ii. Intervention 2: Optimisation of Gastrointestinal Function
iii. Intervention 3: Supplementation and Medicinals
iv. Intervention 4: Detoxification and Chelation
- Sounds Impressive, But Does it Work?
- Harmful and Aggravating Effects
i. Problem 1: Yeast Overgrowth
ii. Problem 2: Candida “Die-Off”
iii. Problem 3: Chelation Side-Effects
iv. Problem 4: Nutritional Imbalances, Deficiencies, and Intolerances
- Homeopathic Perspective on Biomedical Problems
i. Dietary Modifications
iii. Yeast Overgrowth
- Homeopathy and Biomedicine Compared
- Implications of the Biomedical Approach for Homeopathic Treatment
i. Symptoms are Suppressed or Altered
ii. Artificial Symptoms are Produced
iii. The Biomedical Family
- Making the Transition
i. Biomedical Dependency
ii. Biomedicine’s Sophisticated Appearance
iv. Misidentification of Homeopathy
v. Prior Investment
vi. Assisting the Transition
- Biomedicine or Homeopathy?
- Other Interventions
- Orthodox Pharmaceutical Approach
- Behavioural Therapies
- Neurosensory Approach
- Psychodynamic Approach
- To be Continued
Autism is a common term for a number of overlapping syndromes. It has no standard or universally accepted form of treatment, and parents and practitioners alike have access to numerous therapies in trying to improve a child’s autism spectrum disorder (A.S.D.). The use of these other therapies has significant implications for homeopathic treatment. Some approaches, such as dietary changes, can be combined relatively easily with homeopathy; others, such as chelation or neuroleptic drugs, can make homeopathic prescribing almost impossible. If we, as homeopaths, wish to effectively help the A.S.D.-affected children who increasingly present at our clinics, it is important to be familiar with these other competing and often antagonistic strategies and the impact they may have on our treatment.
I have grouped the most common approaches currently in use under the following headings:
1. Biomedical (or biochemical)
2. Orthodox medicine
Of these, the biomedical approach is likely to be the most disruptive to homeopathic treatment. For this reason, a considerable part of this article is devoted to explaining its interventions and the ramifications they have for both patient and homeopath.
The Biomedical Approach: What is It?
Biomedicine is a term that can be applied to almost any form of “medical” practice. Merck defines it as “Clinical medicine based on the principles of the natural sciences such as biology and biochemistry”.1 When used in relation to the treatment of A.S.D.s, it refers to a complicated and developing field on the periphery of orthodox medicine and allied therapies that as of yet has no clearly defined boundary. It seeks to correct biochemical imbalances that disrupt immunological, neurological, digestive, or metabolic processes to create A.S.D. symptoms. To make these corrections, biomedicine may introduce dietary changes; seek to optimise digestion with anti-fungal medications, antibiotics, or probiotics; supplement with vitamins, minerals, and enzymes; detoxify the system by a range of substances; or prescribe medicines to chelate heavy metals out of the body. These interventions are generally guided by the behaviours of the child and the reports from genetic-, salivary-, blood-, urinary-, fÃ¦cal-, or hair-mineral tests.
The relevance of this to the homeopath lies in biomedical interventions’ capacity to complicate homeopathic treatment by suppressing [a] symptoms or by producing new ones as “side-effects”. This, with parents unfamiliar with homeopathic concepts and unlikely to suspend biomedical treatment in favour of homeopathy alone, can make the management of the “biomedical” child particularly challenging. Homoeopathic treatment of such a child will certainly be less clearcut than that of a child not having these interventions; at times, it may even be impossible.
The Four Categories
For the sake of convenience, I have grouped the most common biomedical interventions into the following four categories in the order of their common implementation:
· dietary modification;
· optimisation of gastrointestinal function;
· supplementation; and
· detoxification and chelation.At this point I will provide an uncritical explanation of each, leaving discussion of its benefits, limitations, and drawbacks for later.
Intervention 1: Dietary Modification
The brain and gut are closely linked. Both differentiate from the neural crest during embryologic development, and a preserved link allows them to exert reciprocal regulatory influences on each other later in life: what affects one will affect the other.2 The gut, with many of the same neurotransmitters as the brain and more neurons than the spinal cord, is often called the “second brain”. Many cells of the immune system also reside within the gut to play a major role in immune function. With this knowledge, we are not surprised to find that many A.S.D. children suffer from combined neurodevelopmental problems, gastrointestinal disorders, and lowered immunity.
As the brain-gut connection has been increasingly understood, modifying the diet to remove sensitising or irritating factors has become a major part of the biomedical treatment of autism. It is the platform upon which all other biomedical interventions rest.
Dietary modification consists of three components. First, irritating chemicals such as artificial additives, flavourings, colourings, and preservatives are removed from the diet, along with highly processed foods of little nutritional value.
The second component of dietary modification is the start of a series of biomedical interventions based on allopathic [b] rationale. Dairy products, with their casein content, and gluten-containing foods such as wheat, oats, rye, barley, and spelt are removed from the diet. This is done to prevent any undigested gluten or casein peptides from entering the bloodstream, on the basis of a hypothesis that many children with autism have increased gastrointestinal permeability (often known by the more colourful name of “leaky gut”) that allows undigested casein and gluten peptides to leak into the bloodstream and then circulate to the brain to produce opiate-like effects, including confusion, vagueness, and disorientation – all common symptoms of autism.
The third dietary modification restricts foods that contain sugars or refined carbohydrates. Potentially harmful bacteria such as streptococcus; some viruses; and yeasts such as Candida are fuelled by sugars in the gut to create a state of gut dysbiosis – an excess of certain naturally occurring microbes or parasites. It is thought within biomedical circles that toxins produced by these microorganisms are absorbed into the bloodstream to again affect the brain, and that the dietary restriction of refined carbohydrates and sugars, including those found in fruit and some vegetables, helps to prevent or control these overgrowths.
The above are the main dietary modifications of the biomedical approach, but there are several others. Children may also be on a low-phenol, low-oxalate, or low-salicylate diet; the Feingold diet; the Gut and Psychology Syndrome (GAPS) diet; or the Specific Carbohydrate diet, to name just a few.3
Intervention 2: Optimisation of Gastrointestinal Function
In a healthy state, the gut absorbs nutrients and screens out toxins. If the “leaky gut” hypothesis is correct, it is unable to do either of these two things. The biomedical approach of returning the gut to health involves removing parasites, yeasts, viruses, and toxins and replacing any health-disturbing bacteria with those that are beneficial. To this end, probiotics are combined with the dietary changes already discussed. Antibiotics and anti-fungals are used to “eradicate” unwanted colonies of micro-organisms, and supplementation and chelation of heavy metals may be used in at attempt to reduce gut inflammation and promote healing. (Supplementation and chelation are discussed more in following paragraphs.)
Intervention 3: Supplementation and Medicinals
Biomedicine also uses vitamins, minerals, amino acids, enzymes, hormones, antioxidants, and essential fatty acids – frequently in mega-doses – to treat deficiencies from poor digestion, or to improve immune, metabolic, digestive, and neurological function. Calcium, magnesium, vitamin C, vitamin E, vitamin B5 (pantothenic acid), vitamin B6, methyl B12, melatonin, taurine, dimethylglycine (DMG), pycnogenol, GABA, and fish oil are just some of the more common supplements and medicines prescribed from an extensive and ever-growing list.
Intervention 4: Detoxification and Chelation
It is claimed that chelation is the only means by which some children with autism can be stimulated to excrete retained deposits of mercury, lead, arsenic, and other heavy metals from the body. They may also be affected by one or more of the persistent organic pollutants (POPs) that now contaminate our environment. These include: polyaromatic hydrocarbons and polychlorinated biphenyls (PCBs); aldrin; chlordane; DDT; dieldrin; endrin; heptachlor; and brominated flame retardants. Biomedically, numerous chelating agents and supplements are used to try to relieve any toxic burden these children may carry. They include: dimercaptosuccinic acid (DMSA); 2,3-Dimercapto-1-propanesulfonic acid (DMPS); ethylenediaminetetraacetic acid (EDTA); vitamin C; glutathione; and alpha-lipoic acid (ALA), along with several others.
Sounds Impressive, But Does It Work?
The biomedical model for the treatment of autism is a relatively new and unusual phenomenon: new because the escalating incidence of autism is only recent (1990s onward4), and unusual because biomedical practitioners and their protocols have been, and continue to be, informed by the discoveries of parents who push beyond the limits of orthodox medicine in a desperate bid to find new and better treatment options.5 This “newness” means that very little empirical research is available to scientifically substantiate the claims made by biomedical proponents. Most reports on its effectiveness are anecdotal; though they may be correct, they lack statistical context and often, to a degree, personal medical history. Members of the global A.S.D. community have, out of necessity, had to disseminate home-tested, trial-and-error information on various protocols and strategies between themselves. The immediacy of the Internet; the over-the-counter availability of many medications; and access to the necessary laboratory tests have meant that this parent-to-parent information frequently outstrips the knowledge and protocols of the emerging biomedical practitioners.
As a result, many parents assume sole responsibility for the biomedical treatment of their child. This is evidenced by the increasing number of biomedical self-help groups around the world; their associated non-profit organizations6; and heavily populated biomedical Internet forums7. Lorence, in examining Asperger’s syndrome and the role of these Internet communities, says:
We find that users of web-based information in such areas often report reliance on information for medical decision making and disease management, at times to the point where interaction becomes a form of “cybertherapy”. Further, such groups often evolve into disease-specific, ‘virtual support groups’, even where discussions highlight a lack of consensus regarding the role, function and quality of information within this unique domain.8
Parents who experience gains with biomedical treatment report that their child improves in one or more of the following areas: receptive or expressive language; socialization; behaviour; immunity; and digestive function. All confirm that it is a slow process, and most agree that dietary changes produce the fastest and most consistent improvements. They are clearly also the simplest and safest to initiate.
The biomedical model may appear to be a saviour for some with autism, but the improvements it offers are not consistent over time or even between children of the same parents. For every parent who reports success, another will report failure. Some children will be classified as “non-responders” to treatment; of greater concern, some will regress.9 Biomedicine’s treatments are still evolving, and “best practices” are yet to be defined. Its nebulous grasp on the treatment of autism is revealed in the following words from the Autism Research Unit of the University of Sunderland, UK:
We are gradually approaching an understanding about some of the biological factors which underlie autism and from this we are beginning to develop therapies which appear rational. However, we are still unable to predict with any real confidence how individuals are going to react to the treatments we employ.10
Harmful and Aggravating Effects
It is important to realize that though the “bio” of biomedicine may sound green, clean, and natural, the “medicine” remains deeply allopathic. Most of the treatments depend, for their effect, on biochemical palliation [c] or suppression of symptoms, neither of which will remove the totality of the child’s symptoms.[d] The treatments can also produce harmful or aggravating side effects. The following are four of many such problems.
Problem 1: Yeast overgrowth
An overgrowth of yeast in the gut is the expected side-effect of the chelating agents, antivirals, and antibiotics used during biomedical treatment. According to the “leaky gut” hyypothesis, yeast overgrowth, of which Candida is the most common, increases gut permeability, allowing undigested peptides and toxins into the bloodstream. When such overgrowth is triggered or compounded by chelation, the results can include unbearable itching of the skin and muscles; skin rashes; ear infections; hyperactivity; “stims”[e]; agitation; aggression; abdominal bloating; flatulence; and diarrhoea. Behavioural and cognitive regression can also occur, and the child’s autism may even deepen. To forestall or treat these symptoms, anti-yeast and anti-fungal medications, such as Diflucan (fluconazole), Sporanox (itraconazole), and nystatin may be prescribed; a yeast- and sugar-free diet that “starves” the yeast implemented; or probiotics introduced to “crowd” the yeast out. This layering effect, designed to treat the original iatrogenesis, may or may not be effective but can in turn produce its own problems, including liver and kidney damage. There is also a high risk of the yeast returning in a resistant form upon cessation of treatment. And so, in allopathic fashion, the cycle of symptoms and treatment commences again. A cursory look at biomedical forums reveals many once-hopeful parents struggling to control yeast in their children in a never-ending cycle of symptoms and treatment.
Problem 2: Candida “die-off”
At the other end of the scale, a “die-off” effect, known as the Herxheimer reaction11, frequently occurs as the yeast is starved or poisoned by prescribed supplements, dietary restrictions, or anti-fungals. When this occurs, toxins released by the dying yeast produce a range of symptoms, including hyperactivity; stims; fatigue; brain fog; fever; nausea; gas; bloating; diarrhoea or constipation; abdominal pain; itching; and muscle or joint soreness. Symptoms usually start seven to 12 days after the commencement of treatment. Rather than acknowledging it as the toxic event it really is, die-off is usually presented to parents as an innocuous “detoxing” process. This ignores the fact that the child’s total toxin load is obviously increased rather than reduced during this event and that there is no evidence of increased excretion of existing toxins either during or following the symptoms. Biomedicine will use supplements such as molybdenum, and treatments such as pantethine, activated charcoal, and peppermint oil to try to palliate die-off symptoms.
Problem 3: Chelation Side-Effects
Children with autism often have high levels of heavy metals such as mercury, lead, arsenic, cadmium, copper, nickel, antimony, and aluminium within their system. These metals have all been implicated in causing either neurological damage or gut inflammation. Of them all, mercury has attracted the most attention in biomedical circles. The symptoms of mercury poisoning can be similar to those of autism12, and the opportunities for exposure, either in utero or during infancy, are numerous.[f]
Biomedicine uses a range of supplements and chelating agents to loosen and extract heavy metals, including mercury, from the body, but if toxic side effects are to be avoided, chelation has to be carefully managed. Reversible bone-marrow suppression and elevated liver enzymes, indicating liver damage, have been noted in about 1% of cases. Severe allergic reactions, though rare, have also occurred. Of potentially greater concern is the risk of redistributing sequestered mercury throughout the body, especially to the brain, during chelation. Once there, it is difficult if not impossible to remove. Sections of the biomedical community claim that the chelating agent ALA, being fat-soluble, can cross the blood-brain barrier to extract mercury; but so far, this is not supported by the limited research in this area13. Mercury redistribution to the brain during chelation may also account in part for the regression some children experience on biomedical treatments.14
The less serious side effects of chelation involve bacterial or yeast disturbances (already discussed) and the depletion of essential minerals, such as zinc, copper, manganese, molybdenum, and magnesium. Chelation removes the essential along with the harmful minerals, so careful monitoring and supplementation are vital. Rashes; gastrointestinal disturbances such as reflux, heartburn and diarrhoea; and an increase in autistic and oppositional behaviours are also commonly reported side-effects. The biomedical approach to these problems is not to avoid creating them but to treat them – with additional supplements and medications. Some on the biomedical forums are expressing concern that the development of neurological disorders such as multiple sclerosis and amyotrophic lateral sclerosis later in life by those who have had chelation may in fact be linked to redistribution of metals or to other damage induced by that earlier chelation. It is important to note that, at this point, long-term studies on the safety of chelation have not been done.
Problem 4: Nutritional Imbalances, Deficiencies, and Intolerances
Good nutrition being the basis of good health, removal from the diet of “non-foods” such as artificial additives, flavourings, colourings, and preservatives, along with highly processed foods of little nutritional value, constitutes removal of an obstacle to cure [g]. This simple step of returning the child to real foods often leads to substantial improvements, even in the absence of any other intervention. But dietary restrictions, though amongst the least harmful of all the biomedical approaches, can produce their own nutritional deficiencies. They can also create the very thing they are intended to relieve. When the consumption of “safe” foods is increased to replace those to which the child is intolerant, overexposure can create new sensitivities to the replacement foods and result in further restrictions. At the same time, total withdrawal of some foods can lead to new reactions upon their reintroduction, as the body, having lost the need to digest these foods, will have ceased production of the necessary digestive enzymes. Some children become intolerant of so many foods that parents resort to using hypoallergenic amino-acid-based “milk” formulas such as Neocate either as a supplementary food source or, in extreme cases, as a total food replacement in order to forestall deficiency or starvation.
Biomedical treatments can also create nutritional havoc. The leaching of vital minerals by chelation has already been mentioned. Imbalances from megadoses of supplements can distort the body’s biochemistry. Deficiencies arising from dietary restrictions can also occur. For example, excessive supplementation with zinc, either during chelation or for low zinc levels, will inhibit copper absorption. Copper deficiency then results in anÃ¦mia.15 This phenomenon has been observed several times in biomedical children under my homeopathic care.
Homeopathic Perspective on Biomedical Problems
At this point, it may be appropriate to make a few comments from the homeopathic perspective on these issues of yeast overgrowth or die-off; chelation side-effects; and nutritional imbalances, deficiencies, or intolerances; and on what has been observed in the author’s practice.
Dietary changes, though the safest and simplest to initiate of all the biomedical interventions, are not always without problems. The removal of aggravating foods to help the gut to heal can be a helpful short-term strategy, but it will also remove symptoms important for making a prescription. From time to time, it may be necessary for the child to return to a normal diet so that the full symptom picture can re-emerge and an appropriate prescription made. Some parents may be reluctant to do this for fear of losing hard-won gains.
The improvement in symptoms following food removal while under homeopathic treatment also differs from the improvement following food removal while under biomedical treatment, in that gut healing is much quicker and the period of intolerance far shorter with homeopathic treatment. I have seen many food sensitivities literally disappear overnight in the face of a good homeopathic prescription. In almost all other cases, such sensitivities have taken a little longer to resolve but have been greatly reduced from early in the course of treatment.
It is important for practitioner and parent to realise that the nutritional supplementation of biomedicine is a palliative approach that cannot replace all of the synergistic benefits of real food. Nor can it fully correct the errors of metabolism that create deficiency states in spite of plentiful nutrition. It can create deficiencies, however, as already discussed in relation to Zinc supplementation’s leading to anaemia. In contrast, homeopathic treatment does not leach, block absorption, or create imbalances but normalises the child’s nutrient absorption and metabolism.
Homeopathy rapidly and calmly manages yeast overgrowths (including Candida) if the remedy is individualised to the sufferer’s symptoms rather than given as a routine human symbiode.[h] In my experience, this one thing, more than any other improvement, strengthens parents’ trust and confidence in homeopathy. It is as if parents see “yeast” as the great curse of biomedical treatment – a difficult-to-manage and ever-present threat to the health of their child. When homeopathy rapidly deals with a troubling yeast overgrowth that has been present for months to years in spite of biomedical treatment, and manages this without any unpleasant die-off effects, parents can be understandably elated. They often transfer the long-term care of their child to homeopathy at this point.
One thing to be aware of regarding aggravations, similar or dissimilar, during the course of treatment is that watchful parents may wrongly attribute them to either an overgrowth of yeast or a die-off and lose confidence that homeopathy alone can manage their child’s yeast issues. To avoid this, an explanation about aggravations – their cause and significance – is important in clarifying what is really happening at such times.
When parents are chelating their child, it usually takes many months before an improvement is seen, and years for completion. In contrast, I have repeatedly observed symptoms [i] attributed to heavy-metal toxicity improve within hours of administration of the homeopathic remedy. The removal of heavy metals obviously cannot have occurred within this short period, but it does appear as though the function of metabolic pathways commonly affected by metals can be rapidly “normalised” on exposure to the correct remedy. Interestingly, several of my patients who have had homeopathic treatment without any biomedical interventions show falling levels of heavy metals in their hair-mineral analyses that correspond to the improvements in behaviour and function that occurred whilst on treatment. It is known that the body attempts to naturally remove heavy metal burdens through elimination and excretion pathways. Any remedy that moves that body toward a healthier state will facilitate this process.
Finally, homeopathy does not produce the damaging side-effects common in chelation, either by “loosening” metals or as a direct result of the remedy itself.
Homeopathy and Biomedicine Compared
The main differences between biomedical and homeopathic treatment are summarised in the table on page 18. For those already familiar with homeopathy, many points may be obvious or well known, but they do bear repeating.
1. Homeopathy is a simple and unchanging system of medicine. Its therapeutic action comes from the consistent application of a natural law, the law of similars.[j]
Biomedicine is a conglomerate of complex and changing treatments that vary from practitioner to practitioner, and from year to year. It has no underpinning law to guide practice.
2. Homeopathy is safe. It has no toxic side-effects and will not interact with other prescribed substances. It does not harm.[k]
Biomedicine is capable of toxic side-effects, leaching of vital minerals, and detrimental interactions with other substances. It can and does harm.
3. Homeopathy is based on the observation that an illness or disease can be removed by the short-lived effects of a sufficiently similar second disease of either natural or medicinal origin. Once free of the short-lived effects of the second disease, and no longer suffering from the original disease, the body returns to a state of independent health and homeostasis. Biochemical pathways are restored, and pathogens die out uneventfully.
Biomedicine is based on an assumption that the body’s biochemistry, or a pathogen affecting it, contains the causes, rather than the intermediate effects, of ill-health. It therefore uses chemicals to suppress or control symptoms, force a particular response, or kill the pathogens. Side-effects, overgrowths, and die-off symptoms are common.
4. Homeopathy treats simply and methodically. A single medicine is prescribed according to the presenting symptom complex and the law of similars. Each dose is observed for the type of response it triggers in the unwell person. An improvement followed by a partial return of the original symptoms requires a further dose of the same remedy; an improvement followed by the emergence of new symptoms requires a dose of a newly matching remedy; and so on. In this way, the practitioner moves the patient step by step toward perfect health. (Part one, cases 1, 2, and 3, demonstrate this process.)
Biomedical treatment takes place in cumulative and increasingly complex layers. Medicines are prescribed for their suppressive or palliative effects in opposition to single symptoms. The use of medicines to stimulate rather than suppress the body’s own recuperative efforts is unknown in biomedicine.
5.Homeopathy does not create resistant pathogens or increase food intolerances
Biomedical treatment of pathogens with antibiotics and anti-fungals can lead to re-colonisation by more resistant forms.16 Severe dietary restrictions may increase rather than reduce food intolerances.
6.Compliance is easy with homeopathy. There are no complicated dosage regimes or drastic diets. Homeopathic medicines are pleasant tasting, and doses are small; they are well-tolerated by children.
Compliance can be difficult with biomedicine. Medicines may taste unpleasant or be difficult to swallow. Dietary restrictions can turn meal times into battles, and complicated treatment regimes disturb sleep and disrupt family life.
7.Homeopathic treatment is relatively inexpensive. Consultation fees vary between practitioners, but once treatment has been established, consultations are usually weeks to months apart. Expensive and extensive investigations are not needed, and medicinal costs are low.
Biomedical costs are expensive. Consultation fees vary between practitioners; plans for extended treatment requiring costly investigations and tests, followed by multiple medicines and treatments, are the norm.
8.Homeopathy can frequently improve on biomedical treatment.[l]
Biomedical treatment does not seem to add to improvements produced by good homeopathic prescriptions.[m]
9.When applied according to sound principles, homeopathy has been shown to bring improvement for the great majority of children, and often rapidly.[n]
Biomedical treatment is slow and demanding on parents and children. Results are variable. Whilst some children improve, a significant number, 50% or more, are not helped by many of its approaches, and some regress during treatment.17
Implications of the biomedical approach for homeopathic treatment
Implications of Biomedical Approach for Homeopathic Treatment
The biomedical approach has significant implications for the homeopathic treatment of the A.S.D. child. They fall into three main areas:
1. Symptoms are Suppressed or Altered
Medicines and treatments are only ever given to change, remove, or prevent symptoms; and in the process, the homeopath may lose the very things he or she needs for making an effective prescription. The degree to which this happens with biomedicine varies from intervention to intervention, but even seemingly benign changes such as dietary modifications can cause this problem. An example of this can be found in part one of this article, in Case 1, in which Alex’s dietary changes had significantly modified his behaviours and prevented any expression of food cravings, aversions, or aggravations. Fortunately his mother could still recall what his symptoms were like before the interventions began; many parents simply cannot provide this information, either because too much time has elapsed or because their child was too young to have tried a range of different foods prior to the dietary restrictions. On these occasions, it may be necessary to ask for all interventions to be suspended for a period so that the child’s true symptoms can resurface. In reality, most parents are reluctant to do this for fear that any return of symptoms may permanently set back their child’s improvement. This is especially so in early homeopathic treatment, when the implications of palliation and suppression may be difficult for the parent to grasp. Information and explanation at this time will go a long way to easing any concerns. Sometimes biomedically induced side-effects are so pronounced and widespread that the practitioner can no longer see the true symptom complex for prescribing purposes. If this occurs, there is no option but to suspend treatment until the troubling interventions have been completed and clearer symptoms return. Parent and practitioner should be aware that the completion of chelation may take years.